The Emergency Medicine National Alcohol Screening Day, Academic Emergency Department Collaboration (NASD) project is an opportunity to screen, perform a brief intervention ("teachable moment"), and refer to treatment (SBIRT) those patients identified as at-risk or dependent drinkers. Alcohol abuse is associated with injury, chronic illness, absenteeism from work, and social cost to families and communities. Among Americans age 18 and older, around 5% or 10 million are dependent drinkers, 20% or 40 million are at-risk drinkers, and more than 107,000 alcohol related deaths are reported yearly. The goal in this project is to translate motivational interventions successful in the primary care setting to the emergency department (ED) environment by implementing SBIRT to reduce at-risk drinking among ED patients. Multiple academic departments of emergency medicine will collaborate on this project. Approximately 500 ED patients will be enrolled at each of the study sites, with half of those patients being in the control group, and the other half receiving motivational intervention. Volunteer research assistants will be trained to screen patients, and emergency department healthcare providers will provide brief motivational intervention and treatment referral. Training and positive experiences with SBIRT, should enhance SBIRT adoption by ED personnel, and among persons identified with at-risk drinking in the ED setting SBIRT should result in a significantly decreased frequency and quantity of self-reported alcohol use, reduce alcohol related risk factors, and increase completion of referrals in the intervention group at three and six month follow-up, compared to a control group that receives only written advice. [unreadable] [unreadable]